Monday, November 12, 2007

Not Quite Ready to Leave ICU

So I got a call at 7:00 a.m. this morning that Ava had a slight fever again. Her lactate was increased but still within normal. Her white blood cell count was up too. Again they took cultures to determine if there is an infection. Since then her lactate is back down and her fever is gone. Won't know about cultures or white blood cell counts until tonight/tomorrow morning. Ava's heart rate, respiratory rate, and blood pressure are a bit on the high side. She looks really good, though. What does all this mean? The cardiologists are not real concerned but are keeping her in ICU to be cautious. In fact, during rounds this morning they joked that she caught wind of going to Moderate Care and decided to act up just enough to stay in ICU. I am just so thankful that this happened while she was still in ICU and not after we went to Moderate Care. She will still probably go to MC sometime this week unless something else comes up.

I forgot to mention that Brayden got to hold Ava for the first time this weekend. He was so happy! I've been doing a lot of holding lately, too, which is so comforting for both of us. The nurses even got Jamie involved in holding/caring for Ava over the weekend. He's a bit fearful about how delicate she is. I'm glad they are pushing him a bit so he can overcome this nervousness.

Candais and Ke'Myiah are back in Moderate Care because of some oxygen problems she was having over the weekend. They hope to go home maybe next week. Please continue to pray for her along with Ava. Also, pray that I can handle anything that comes my way this week!

20 comments:

Anonymous said...

jamie, those pictures are sooo sweet. What a cutie, and what a handsome big brother also. How much fun is heather going to have doing ava's hair?! I'm praying that thing's go as planned, be strong and be healthy.
love, erin

Anonymous said...

Jamie,
Thanks so much for the new pictures! Ava is absolutely beautiful and seems to have already changed so much since I saw her! Be strong this week. We will keep you all in our prayers.
Love,
Emilee

Molly Brawley said...

OMG!!! She looks like cousin Justin with that crazy hair. She is just too cute for words--I can't stand it.

I am also glad she spiked the temp before getting to Moderate Care--also glad the docs aren't too worried. You sound great Jamie and some day you will realize what a fighter YOU are...AMAZING!

Molly

Anonymous said...

Hey Brayden,
I guess Ava has "Crazy Hair" like Grandma.
Jamie, That is so cute! What happened? I never realized her eyes where so big! Boy, I have to tell you she sure does have the "Thomas" in her. And Molly is right, she does look like Justin!!LOL
We will see you hopefully on Wed. of this week.
Take care, We love you and yours.
Wilma

Anonymous said...

Thanks for the pics Jame! She is an absolute doll! But, be careful of Heather getting ahold of Ava's hair, remember Stephanie's BIG hair! Just kiddin Heath!
Love U, Trace

Molly Brawley said...

Ok, it's me again. I figured it out--Ava looks like Girl Jamie! Look at those eyes and her chin. By the way, how much has she grown? She looks so good. No one would know the fight she has fought to look at her. Again, what an amazing little girl.

Anonymous said...

Ava is adorable! It made my day to bring up the blog and see her sweet little face looking back at me. Today was'nt her day to go to MC, maybe tomorrow-I have a feeling she will let you know.
Take care,
The Meek's

Michelle Asmus said...

Jamie-
She is BEAUTIFUL!! Looking at the first picture you have posted you would never know all that she has been through.
I agree with Molly. She does look like you, Jamie.
Keep your faith-
Love, M

Anonymous said...

Oh my Gosh! Ava is absolutely adorable!!! I am loving that hair and her big beautiful eyes! She looks like she is doing great. Jamie, you look wonderful! Can't even tell you had a baby or that you've been through so much! You are such an amazing, strong, inspirational person! Ava is ALWAYS in our thoughts and prayers and we look forward to hearing about her progress every day! Thank you for sharing the new pics!

God bless,
Becky Asmus

Anonymous said...

Oh my gosh Jamie, I thought I had such a great updated pic of Ms. Ava-but yours beats out mine by far. Her eyes look so big!
she reminds me of Justin in his long hair days! ha. Anywsy, you can do what ever coms your way. That has been proven over the years and especially the last 2 months. You and boy jamie will be the best ever at helping your daughter. Please believe that. Thank God Ava-you are still fighting.
we love you
granny and poppy

Anonymous said...

Jamie-I wrote my thing and then read others. My word- Im not alone abouth the Justin thing. But she does look like you and Wilma and your dad and jamison and Justin! What a mix! Your cheeks, Jamison mouth, Justins hair and just something?? Plus- She does have big eyes!! from me????haha private joke. I love to take credit for something!ha Anyway-she is beautiful!!!!!!!!!!!!!!!!!!!!!!!!!
love all of you
getting your boys some food
Petes pizza for jamie and what from Wings?

Anonymous said...

Jamie,

I just love that first picture!!! What a cutie, she is so perfect. I can't believe how much she has changed. It looks like her hair is ready for some bows.

Jamie I pray that your week goes smoothly and that the doctors know just the right time to move her to moderate care.

Just remember Jamie, no matter how hard it is, try and take advantage of all these experts while you have them, and rest up as much as you can now before you come home. I'm hoping that time is soon. So you can be with both your little ones.
Ava looks great!
Take care,
Janelle

Anonymous said...

Jamie - you have a beautiful little angel! Brayden looks very proud and he will make a wonderful hands on big brother! Keep the faith and remember you are all in our prayers each day. You will all be home together very soon! Take care of yourself.

Ginger Andres

Anonymous said...

Jamie,

Ava looks so beautiful. I love all that hair. It is amaizing how much she has changed in the last few weeks. She looks so happy and strong. The four of you will be home together before you know it! Take care. We think of you often.

Tori and family

Anonymous said...

Good morning sweet Ava. I pray you had a good night. Be strong today and help your mom be strong. We all love you so much. I cant wait to hold your little hand again. You have such a good grip!!!!!!!!
we love you
granny and poppy

Sara Grishaber said...

Jamie,

Thank you for the updated pictures. It's amazing at how much she has changes since we came to see you guys. She is so beautiful! We'll be praying that the rest of the week goes well.

Love,
Sara

karen said...

Jamie,
The new pictures are great! You can see how far she has come. Love Ava's hair. I knew the vocal folds would be fine. They just need to stay away from all those tubes. She'll be talking before you know it. I miss you at school but know you are doing your most important work with Ava and Bray.
Howard-Ellis is just a little less bright without you around. Your class is doing fine. Can't wait for Ava to see her real home.
Love,
Karen Kellogg

Anonymous said...

Just seen Ava's glamour shot's. So cool! As always my prayers are with all of you. Stay strong in the belief Ava will beat this and you all will be coming home. Love you all Aunt Kathy.

Anonymous said...

Jamie and Jamie, Your little girl is absolutely beautiful...seeing her pictures, I realized that she has the full,curly head of hair that I've wished for all my life!! Truly, it's wonderful to see her updated photos, and know that she's moving in a positive direction. We continue to pray every day for her, for you, and for those amazing people who are helping you care for her! With love, Gretchen

Anonymous said...

Just had to comment.
LOVE THE HAIR!!
the new photos are so sweet.
I Think of you and your family often.

Joyce Miller

Ava with Mommy & Daddy

Ava with Mommy & Daddy
Isn't she beautiful!

It's A Girl!

Hello everyone and welcome to Ava Christine's Blog.
First a little info about the new edition to our family.
This beautiful little girl comes to our family after many years of trying on her parents part as well as her being the first girl in 19 years. Yes 19 years! So to say that she is going to be a little spoiled is putting it very lightly.
Ava Christine was welcomed into this world on September 29 2007 by her mommy Jamie, Daddy Jamie, big brother Brayden, grandparents, aunts, uncles, cousins, and numerous friends. Shortly after Ava's arrival the wonderful medical staff at Memorial hospital of South Bend found what they called a murmur in Ava's heart. After some testing little Ava was transported to Motts' Children Hospital at the University of Michigan in Ann Arbor. Jamie and Jamie were informed that little Ava has a heart defect that could be life threatening and that she needed to undergo open heart surgery to fix the defects. So, on Tuesday October 2 2007 Ava was operated on by the wonderful medical staff at the U of M. What this team of doctors did to Ava is incredible. First of all Jamie explained to me over the phone today just what problems Ava's heart has endured. Ava's heart has a couple of different problems. The first is known as Interrupted Aortic Arch. The following info about interrupted aortic arch is best explained by the U of M Cardiac website, "Interrupted aortic arch is a very rare heart defect that occurs when the aorta does not develop normally while the baby is in the mother’s womb. It comprises about 1% of all congenital heart defects. It usually occurs along with other heart problems such as truncus arteriosus, ventricular septal defect, transposition of the great arteries, and aortic stenosis.The aorta is the large blood vessel that arises from the left side of the normal heart and takes red blood out to the body. The first part of the aorta, called the ascending aorta (1) arises upwards. It then curves leftward forming the aortic arch (2). The aorta then curves downward towards the lower body, and this part is called the descending aorta (3). Three blood vessels exit from the aortic arch and supply the head and arms with red blood. These vessels are called the innominate artery (4), the left carotid artery (5), and the left subclavian artery (6).In babies with interrupted aortic arch, there is a complete blockage between the ascending and the descending aorta (1). This means that there is no direct way for red blood leaving the heart to reach the body parts that are "downstream" from the blockage. The site of the defect varies (2) and may or may not involve the take-off of the head and neck vessels. In most babies with interrupted aortic arch (70-90%) there is also a large ventricular septal defect (3).In newborns with interrupted aortic arch, the only way for blood to bypass the blockage is via the patent ductus arteriosus (4). Prior to birth, this small blood vessel permits blood to by-pass the baby’s fluid-filled lungs. One or two days after birth, this vessel usually closes on its own. In a baby with interrupted aortic arch, if the duct closes, blood can no longer reach the lower body. This can cause the baby to suddenly become very ill. Therefore, after the diagnosis is made, a medicine called prostaglandin is used to keep the ductus arteriosus open until surgery". (http://www.med.umich.edu/cvc/mchc/parint.htm)
So how did the doctors fix this? "Interrupted aortic arch is a serious heart defect that requires surgery soon after birth. The goal of surgery is to create remove the blockage. This used to be done in a two-stage operation but is now done most of the time in one stage. The two ends of the aorta are sewn together (1) and the patent ductus arterious (2) is tied off. Sometimes a patch is needed to reinforce the repair. If present, a patch is sewn over the VSD (3)". (http://www.med.umich.edu/cvc/mchc/parint.htm)
In #1 of the picture below is the part of Ava' heart that was repaired.

Before surgery

Before surgery

The Next Step

The next step in repairing Ava's heart was to fix what is known as Truncus Arteriosus. Truncus arteriosus is "characterized by a large ventricular septal defect over which a large, single great vessel (truncus) arises. This single great vessel carries blood both to the body and to the lungs". (http://www.americanheart.org/presenter.jhtml?identifier=11073) Below is a picture of what Ava's heart was like before surgery.

Before Surgery

Before Surgery

After Surgery

After Surgery
The above picture shows what the surgeon did to repair Ava's heart. "Surgery is required to close the ventricular septal defect and separate blood flow to the body from blood flow to the lungs. This is generally done early in infancy to prevent high blood pressure from damaging the lungs' arteries. A patch is used to close the ventricular defect. The pulmonary arteries are then disconnected from the single great vessel and a tube (a conduit or tunnel) is placed from the right ventricle to these pulmonary arteries. This is sometimes called a Rastelli repair". (http://www.americanheart.org/presenter.jhtml?identifier=11073)